Dermatology

The residency program in Dermatology at the Ohio State University provides advanced clinical training and specialization in the diagnosis and treatment of skin diseases of small and large animals under the supervision of 3 board-certified specialists. Faculty members are nationally and internationally recognized leaders in their respective fields. The residency is a 3-year combined residency and graduate studies program leading to a Certificate of Residency and Master of Science degree.

Training is designed to insure development of clinical competence in dermatology by facilitating development of clinical proficiency, clinical skills, and knowledge of dermatology through exposure to a wide variety of cases at all levels of complexity. This goal is facilitated by location of the Veterinary Medical Center in a large metropolitan area (population over 1.5 million) that provides a rich variety of case material as well as a referral base that includes Ohio, Indiana, Pennsylvania, Kentucky, West Virginia and Michigan. In recent years, a majority of referrals have come from within Ohio. State-of-the-art equipment and facilities are available to develop technical expertise in diagnostic and therapeutic procedures.

All residents at The Ohio State University have to complete a significant piece of original research that forms the basis of their thesis to meet requirements for obtaining their MS degree. The research thesis has to be completed and defended prior to completion of the 3-year training program. We believe that completion of the MS degree provides significant advantages to the resident in their maturation and development as a dermatologist. Regardless of the residents anticipated career (private practice, academia, research, or industry), the completion of advanced didactic courses (for example; biostatistics, immunology, pharmacology) and significant research as a principal investigator provide insights and understanding that are rarely achieved in clinical residency programs.

Objectives

The objectives of the program are for the resident to:

Develop comprehensive, state-of-the-art expertise and clinical proficiency in dermatology;
Satisfy the criteria necessary to qualify for Board Certification, and to prepare the resident for successful completion of the American College of Veterinary Dermatology Certification Examination;
Prepare for future career goals of teaching, clinical research, scientific publication, or specialized practice; and
Complete a Master of Science or PhD degree in a specific area of research endeavor related to dermatology.

Faculty and staff

Faculty

Dr. Andrew Hillier
Professor and Head of Dermatology and Otology
BVSc, MACVSc, Dipl. ACVD
andrew [dot] hilliar [at] cvm [dot] osu [dot] edu
Dr. Lynette Cole
Associate Professor
DVM, MS, Dipl. ACVD
lynette [dot] cole [at] cvm [dot] osu [dot] edu
Dr. Wendy Lorch
Assistant Professor
DVM, MS, Dipl. ACVD
gwendolen [dot] lorch [at] cvm [dot] osu [dot] edu

Current residents

Dr. Holly Roberts, DVM (residency July 2011 - July 2014)
Dr. Melanie Hnot, DVM (residency July 2012 - July 2015)

Dermatology staff

Deb Crosier (Dermatology technician)

Prerequisites and application

All potential residents in dermatology must meet the minimum requirements and qualifications as outlined in the Graduate Program Handbook of the College of Veterinary Medicine and the Graduate School Handbook at The Ohio State University.
Currently admission requirements include: a minimum 3.0 GPA during undergraduate and professional (veterinary degree) studies;
- a minimum 3.3 GPA for all graduate coursework;
- submission of the results of the GRE (Graduate Record Examination). GRE scores must have a verbal score higher than the 25^th percentile and quantitative score higher than the 50^th percentile. The GRE requirement may be waived for international veterinarians;
- and foreign applicants must meet the Graduate School Admissions requirements for the Test of English as a Foreign Language (TOEFL) (currently 550 for the paper-based test, 213 for the computer-based test, and 79 for the internet-based test).
The residency in dermatology is a formalized program approved by the American College of Veterinary Dermatology (ACVD). As such, all residents must:
- Be a graduate of an approved veterinary school or college.
- Have completed a one-year internship or practice equivalency.
- Be approved to practice veterinary medicine in a state of the United States of America, province of Canada, or country of citizenship.
- Be a member of a National Veterinary Medical Association (e.g. AVMA).
- Be of satisfactory moral and ethical character including but not restricted to being honest and truthful, not be habitually intoxicated or addicted to drugs, and not to have been convicted of cruelty to animals
The dermatology faculty require that each potential applicant either interview personally during an official visit to The Ohio State University or, at least, complete a telephone interview with each faculty member.
Residents who are foreign nationals (non-US citizens) must be in possession of the appropriate visas and work authorization as outlined in the Department of Veterinary Clinical Sciences Residency Program Handbook. In addition, foreign nationals must also meet the requirements of the university Graduate School for the Test of English as a Foreign Languages (TOEFL) or Michigan Test of English Proficiency (MTELP) – see Graduate Program Handbook of the CVM and the Graduate School Handbook and above.

Employment and benefits

Residency Program Handbook

Salary
Health insurance
Book/travel allowance
Personal + Professional days leave (from policy)
External consultation and employment
Licensure

Orientation

During the first week of the residency program, all incoming residents participate in a comprehensive orientation program to introduce them to the department, college and university, complete necessary documentation, and to facilitate integration into our program and activities.
Following the general orientation program for all residents, new dermatology residents will meet with the faculty to discuss and plan the initial few weeks and months of the first year of the residency.
Typically, new residents will spend the first few days or weeks on clinical duty in an observatory capacity. Thereafter, new residents will take primary case responsibility and discuss each and every case with the duty faculty clinician before deciding on diagnostic approach and therapeutic management of the case. This period is variable dependent on the clinical knowledge and skills of the resident.

Advisors and mentoring

Clinical advisors

Each of the dermatology faculty members will serve in an equal capacity as clinical advisors. Residents will take advice and input form the duty dermatologist and follow-up advice on cases will typically also be with the dermatologist on duty at the time the case was seen. General group discussion of cases also occurs during the regular dermatology service meeting on Tuesdays at noon or informally as the need arises.

Academic advisor

The principal academic advisor is decided once the area of research is decided. Until that time, both dermatologists are involved in initial discussions and planning of the direction of the resident's research. The dermatologist who is not the academic advisor to the resident will always serve on the advisory and examination committees for the MS degree.

Thesis committee

Once the specific area of research is selected, an Advisory committee will be formed that will consist of the academic advisor, the dermatology faculty and any other faculty members who may be able to provide advice in the development of a specific research project, during the project and to completion of the study. Typically, the Advisory committee serves as the Examination committee for the thesis defense. These committees must consist of at least 3 graduate faculty members.

Mentoring

The dermatology faculty members serve as mentors throughout the course of the residency, graduate course program and research project. We regard mentoring of our residents as one of our most important, and most enjoyable, duties. We are committed to providing support, guidance and help in all aspects of their professional lives during the course of the residency. We care about our resident's professional and personal development and aim to assist our residents in being the best that they can possibly be and to prepare them for successful careers in dermatology.

Clinical Service responsibilities

Dermatology service clinical operation

When the resident is on clinical duty, we have a full program of activities such as receiving patients, performing procedures, and rounds that takes up the full day. Please see Appendix for a typical weekly schedule that indicates the time of each activity.

Clinical duty

The residents see patients with the duty faculty clinician – the cases are shared between the two residents with oversight from the faculty clinician. If one of the residents is off clinics, then the duty faculty clinician and the other resident will share case responsibility. Initially, residents will discuss the full details of each case with the faculty clinician prior to meeting with the pet owner. As their experience and competence level grows, residents are only required to provide the faculty clinician with an overview of the case. Owner requests for a specific clinician (at recheck visits) are usually honored. The faculty clinician may request that a resident take primary case responsibility for a specific case if it is a good learning case, provides unique opportunities etc. The residents share primary case responsibility for all in-house consults requested from other specialty services – initially these will be reviewed by the faculty clinician similar to our own patients. When residents are on clinical service, they will also share and be responsible for all telephone consultations from our referral DVMs.

Expectations of development of clinical knowledge and skills

One of the main initial goals is for the resident to develop adequate clinical skills and knowledge to be able to take responsibility for the average patient that is referred to the VMC. The time this takes depends on the level of experience and the progression of the resident, but this point should be reached by the end of the 1^st year of the residency. During the 2^nd year, we expect the resident to develop insights and understanding that will allow them to approach more complex cases with logic and understanding, and by the 3^rd year, we expect the resident to be able to be in control of almost any patient that they see, regardless of the complexity or uniqueness of the case.

Faculty oversight and mentoring

As mentioned previously, the dermatology faculty regards resident training and mentoring as one of their most important tasks. We are always available for discussion and advice on clinical, research and graduate program concerns. We aim to provide a structured program that ensures the development and growth of the resident, while at the same time retaining flexibility to accommodate each resident individually, such that at the completion of the program we are certain that our residents will be skilled, knowledgeable and able to pursue with confidence any career and opportunity in veterinary dermatology that they would like.

Emergency duty

The dermatology resident is expected to be available for any dermatology emergency seen at the VMC. As such, a dermatology resident is always "on call" for these emergencies, although they are few and far between. Emergency duty for dermatology emergencies is shared equally by the dermatology residents. Dermatology residents do not participate in any "regular" emergency duty for the VMC.

Time off clinics

Time off clinics: Policies for time off clinics are standard for all residents and can be reviewed in the Residency Handbook. In brief, each resident is allocated 24 weeks off clinics over the course of 3 years. The 24 weeks includes personal leave time (2 weeks/year) and professional leave (3 weeks over the entire 3 years), with a balance of 15 weeks for scholarly activities. A special request can be made for up to 6 additional weeks off clinics – this must be justified for completion of resident research studies or other acceptable activities. It should be noted that residents will not be allowed to accrue this “off clinic” time such that is taken all at once in the 3^rd year for boards preparation or the like.

Teaching responsibilities

Clinic

Residents will be expected to participate fully in the teaching of senior veterinary students rotating through the dermatology service which includes discussion of cases and performing diagnostic procedures

Rounds

Residents will be expected to be in rounds on all occasions when on clinical service unless they are attending a graduate class. Within the first 3 to 6 months of the residency, residents will be expected to contribute to rounds by leading discussion of their cases, answering student questions, stimulating students to develop core dermatologic knowledge and leading discussion on specific topics.

Seminars

Please see the appendix for the weekly schedule. The dermatology group meets on Thursday mornings for Journal Club (except the 2^nd week of the month when we meet on a Tuesday morning with local area dermatologists for Journal Club), and on Friday mornings of dermatohistopathology. Book review occurs on Monday mornings except the first Monday of the month when all residents and faculty attend the departmental Research Seminar

Journal club

Journal club typically includes discussion and critique of 3 recent journal articles selected and led by either one of the residents or our visiting dermatologists (if they are attending) on an equal rotational roster. Reviewed journals include all of those recommended by the ACVD, plus others containing articles recommended for resident review. Three articles are reviewed at each journal club. The Ohio State University has on-line access to all currently available digital format journals, as well as most print journals. For non-digital back issues that are not maintained in the University's subscription database, inter-library loan assures access within 3 business days.

Book review

Over the course of the 3-year program, book review sessions of selected textbooks that may include (amongst others) Muller + Kirk's Small Animal Dermatology, Scott’s Equine Dermatology and relevant chapters from Scott's Large Animal Dermatology, Medleau + Hnilica’s Small Animal Dermatology, Greene’s Infectious Diseases, Feldman and Nelson’s Endocrinology, Gross et al’s Dermatopathology, all volumes of Advances in Veterinary Dermatology as well as relevant issues of Vet Clinics of North America. Review sessions of text books (in conjunction with formal Integumentary didactic courses – see below) are designed to help the resident develop study notes in preparation for the ACVD board certifying examinations.

Dermatopathology rounds

Residents attend dermatopathology rounds with the preceptors, at least two ACVP pathologists, and residents in pathology for 1 hour every month (see chart) – 1^st Friday of the month. This hour is dedicated to the review of the case material provided by the dermatology residents, preceptors and the pathology service. On the weeks where the resident and preceptors do not meet with the pathology service (i.e. 3-4 x monthly), the resident and preceptors review their own case material as well as sections from our bank of histopathology slides. Initially, the preceptors provided hands on guidance, followed later by giving the resident slides to review prior to the session and then presenting these slides to the preceptors, and finally, unknowns are given to the residents for their description/ diagnosis at the time of the session.

Didactic teaching to professional students

Dermatology residents are asked to provide a "National boards dermatology review" to the senior veterinary students annually. In addition, there is the opportunity for residents in their 2^nd or 3^rd year to contribute 1 or 2 hours of lectures in the didactic Integumentary course taught to the sophomore class each spring quarter – this is an option and not a requirement.

Interns and other residents

Some small animal interns elect to rotate through dermatology for 1 week. The interns participate in rounds and Thursday morning seminars and the resident is expected to provide clinical guidance to the interns as they observe receiving.

Educational opportunities

The residency is a structured program whereby we will complete reviews and discussion of all basic science and clinical teaching pertinent to dermatology during the Thursday seminars. The faculty has a series of lectures on skin structure and function which form an integral part of the learning process. Further, the faculty maintains extensive personal libraries of textbooks and journal articles that are available to the resident at all times.
As part of their MS degree program, residents must complete 20 credit hours of didactic coursework in the semester curriculum that will be implemented in Summer 2012. Courses are offered at the College of Veterinary Medicine as well as by other colleges at The Ohio State University. Typically, courses that are taken include immunology, research methods, and biostatistics, amongst others.
In addition the dermatology faculty conduct courses on Comparative Structure + Function of the skin, Advanced Otology + Audiology, and Dermatopathology which contribute significantly to the credit hour requirement.
Residents are expected to attend the Residents Forum at the North American Dermatology Forum annually. The ACVD hosts this 2-day forum that provides approximately 16 hours of intensive didactic lectures presented by recognized experts that serve as a foundation for board examination preparation.
External educational opportunities such as externships are encouraged. These rotations of 1 week or more should be used to supplement the learning experience for the resident, for example, gaining exposure to species dermatology not often seen at our hospital or research training associated with the MS thesis. As described in the Residency Handbook, each resident is granted 15 professional days of leave over the course of the 3-year program for such activities. With the support of the academic advisor and service head, additional professional leave days (more than 15 days) may be requested for external educational experiences.
Other educational opportunities: The resident will attend the regular scientific sessions at the North American Dermatology Forum following the residents forum each year. In addition, resident are encouraged to attend any local continuing education conferences such as the Midwest Veterinary Conference, the Royal Canin/OSU conference etc. where material pertinent to their education is presented.

Graduate program

As part of their MS degree program, residents have to complete 20 credit hours of didactic coursework – see above. In the past, dermatology residents have fulfilled their didactic coursework requirements by the end of the 2^nd year or early in the 3^rd year of their programs.
Details of the formal requirements for completion of the MS degree can be found in the Graduate Program Handbook of the CVM.

Research and scholarly activity

As required by the ACVD, a research project will be planned and executed by the resident during the 3-year training period. Guidance is provided in preparing a grant proposal to seek intra- and extramural funding. All of our residents have to complete a significant piece of original research that forms the basis of their thesis to meet requirements for obtaining their MS degree. The research is typically hypothesis-driven and may be clinical or laboratory-based depending on the selected area of study. In the past, our residents research has often been in collaboration with other scientists within our department, in other departments at the CVM, in other colleges at OSU or researchers outside of OSU. The research thesis has to be completed and defended prior to completion of the 3-year training program, and granting of a residency certificate is dependent on successful completion of the MS degree.

Scientific presentations

The resident must present the results of their research project during the annual meeting of the ACVD (North American Veterinary Dermatology Forum) during the third year of their residency. A poster abstract and presentation of the residents research is also made at the CVM Research Day in April each year. Finally, the Dept. of Veterinary Clinical Sciences also requires each resident to present their research during a research seminar to the faculty in their senior year.

Publications

The resident must publish the findings of their research in at least 1 manuscript in a peer-reviewed journal. This is a requirement of the ACVD Credentials committee and for completion of the MS degree. In the past, our residents have published 2 or 3 manuscripts emanating from their MS research project in highly regarded journals such as the Journal of the American Veterinary Medical Association, American Journal of Veterinary Research and Veterinary Dermatology. These published articles are included in the MS thesis.

Evaluations

Department of Veterinary Clinical Sciences

Formal Resident Performance Evaluations are completed by December 1^st and June 1^st each year. Details of the nature and structure of these evaluations can be found in the Residency Handbook.

ACVD evaluations

The ACVD requires that residents are evaluated by their mentors after 4.5 and 12 months of their programs and annually thereafter.

Specialty college requirements

Additional requirements for successful completion of the residency as mandated by the ACVD may be found in the Residency program guidelines, Residency Timelines, Case log documents provided and updated annually by the Education committee of the ACVD.

Board certification

We offer a comprehensive didactic and clinical training program that we believe provides excellent preparation for successful completion of the ACVD board certifying examinations. Since 1992, all of the dermatology residents at OSU have obtained their MS degree and all have passed the board certifying examinations (3 on the 1^st attempt and 1 on the 2^nd attempt).
It is important that our residents realize that although eventual board certification is clearly anticipated, our primary goal of our training program is to encourage and assist our residents in becoming highly skilled and expert dermatologists.

Appendices

Draft biweekly schedule

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